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Introduction: During development and regeneration, odontogenesis and osteogenesis are initiated by a cascade of signals driven by several master regulatory genes., Methods: In this study, we investigated the differential expression of 84 stem cell-related genes in dental pulp cells (DPCs) and periodontal ligament cells (PDLCs) undergoing odontogenic/osteogenic differentiation., Results: Our results showed that, although there was considerable overlap, certain genes had more differential expression in PDLCs than in DPCs. CCND2, DLL1, and MME were the major upregulated genes in both PDLCs and DPCs, whereas KRT15 was the only gene significantly downregulated in PDLCs and DPCs in both odontogenic and osteogenic differentiation. Interestingly, a large number of regulatory genes in odontogenic and osteogenic differentiation interact or crosstalk via Notch, Wnt, transforming growth factor beta (TGF-beta)/bone morphogenic protein (BMP), and cadherin signaling pathways, such as the regulation of APC, DLL1, CCND2, BMP2, and CDH1. Using a rat dental pulp and periodontal defect model, the expression and distribution of both BMP2 and CDH1 have been verified for their spatial localization in dental pulp and periodontal tissue regeneration., Conclusions: This study has generated an overview of stem cell-related gene expression in DPCs and PDLCs during odontogenic/osteogenic differentiation and revealed that these genes may interact through the Notch, Wnt, TGF-beta/BMP, and cadherin signaling pathways to play a crucial role in determining the fate of dental derived cell and dental tissue regeneration. These findings provided a new insight into the molecular mechanisms of the dental tissue mineralization and regeneration.

Introduction: Several case reports on endodontic regeneration involving immature permanent teeth have recently been published. These case series have used varying treatments to achieve endodontic regeneration including triple antibiotic paste, Ca(OH)(2), and formocresol. However, no study has analyzed the overall results., Methods: In this retrospective study, we collected radiographs from 54 published and unpublished endodontic regenerative cases and 40 control cases (20 apexification and 20 nonsurgical root canal treatments) and used a geometrical imaging program, NIH ImageJ with TurboReg plug-in, to minimize potential differences in angulations between the preoperative and recall images and to calculate continued development of root length and dentin wall thickness., Results: The comparison to the 2 control groups provided a validation test for this method. Forty-eight of the 54 regenerative cases (89%) had radiographs of sufficiently similar orientation to permit analysis. The results showed regenerative endodontic treatment with triple antibiotic paste (P < .001) and Ca(OH)(2) (P < .001) produced significantly greater increases in root length than either the MTA apexification or NSRCT control groups. The triple antibiotic paste produced significantly greater differences in root wall thickness than either the Ca(OH)(2) or formocresol groups (P < .05 for both). The position of Ca(OH)(2) also influenced the outcome. When Ca(OH)(2) was radiographically restricted to the coronal half of the root canal system, it produced better results than when it was placed beyond the coronal half., Conclusions: Ca(OH)(2) and triple antibiotic paste when used as an intracanal medicament in immature necrotic teeth can help promote further development of the pulp-dentin complex.

Dentin, the mineralized tissue forming the bulk of the tooth, serves as an energy-absorbing cushion for the hard, wear-resistant enamel and protects the inner soft tissues. Several studies used fracture mechanics methods to study the fracture toughness of dentin. However, all of them utilized precracks and cannot be used to estimate the intrinsic critical flaw size of dentin. We applied quantitative fractography to study the fracture pattern and fracture toughness of human dentin. Sixteen specimens were prepared from the coronal dentin and fractured in three-point flexure. Fracture surfaces were examined using a scanning electron microscope and the fracture toughness was calculated using a fracture mechanics equation. It was found that human dentin has a fracture surface similar to those of brittle materials. Twist hackle markings were observed and were used to identify the fracture origins. Average fracture toughness of all specimens was found to be 2.3 MPa m(1/2) and the average critical flaw size was estimated to 120 mum. It is suggested that fractography is a promising technique in analyzing the fracture of dentin under catastrophic failure.

An evaluation of the crack growth resistance of human coronal dentin was performed on tissue obtained from patients between ages 18 and 83. Stable crack extension was achieved over clinically relevant lengths (0< or = a < or =1mm) under Mode I quasi-static loading and perpendicular to the nominal tubule direction. Results distinguished that human dentin exhibits an increase in crack growth resistance with extension (i.e. rising R-curve) and that there is a significant reduction in both the initiation (K(o)) and plateau (K(p)) components of toughness with patient age. In the young dentin (18< or =age< or =35) there was a 25% increase in the crack growth resistance from the onset of extension (K(o)=1.34 MPa m(0.5)) to the maximum or "plateau" toughness (K(p)=1.65 MPa m(0.5)). In comparison, the crack growth resistance of the old dentin (55< or =age) increased with extension by less than 10% from K(o)=1.08 MPa m(0.5) to K(p)=1.17 MPa m(0.5). In young dentin toughening was achieved by a combination of inelastic deformation of the mineralized collagen matrix and microcracking of the peritubular cuffs. These mechanisms facilitated further toughening via the development of unbroken ligaments of tissue and posterior crack-bridging. Microstructural changes with aging decreased the capacity for near-tip inelastic deformation and microcracking of the tubules, which in turn suppressed the formation of unbroken ligaments and the degree of extrinsic toughening.

Purpose: The purpose of this study was to investigate dentin rehardening in the remaining carious dentin after indirect pulp treatment (IPT) using microhardness analysis after 37 to 71 months., Methods: Eighteen teeth submitted to IPT and capped with calcium hydroxide (CH) or gutta-percha (GP) were evaluated (treated group). Ten sound molars and 10 molars with deep acute carious lesions were selected to serve as positive and negative control groups, respectively. In the treated group, restorations and pulp-capping materials were removed. In the positive control group, 3- to 4-mm deep cavities were prepared. In the negative control group, the carious tissue was removed. Microhardness analysis was performed at 10-, 35-, 60-, 85-, and 110-microm depths. Data were analyzed using 1-way analysis of variance (P<.05)., Results: Microhardness values for sound, carious, and treated groups at 10-, 35-, 60-, 85-, and 110-microm depths showed a statistically significant difference (P

The definition of an optimal elastic modulus for a post is controversial. This work hypothesized that the influence of the posts' elastic modulus on dentin stress concentration is dependent on the load direction. The objective was to evaluate, using finite element analysis, the maximum principal stress (sigma(max)) on the root, using posts with different elastic modulus submitted to different loading directions. Nine 3D models were built, representing the dentin root, gutta-percha, a conical post and the cortical bone. The softwares used were: MSC.PATRAN2005r2 (preprocessing) and MSC.Marc2005r2 (processing). Load of 100 N was applied, varying the directions (0 degrees, 45 degrees and 90 degrees) in relation to the post's long axis. The magnitude and direction of the sigma(max) were recorded. At the 45 degrees and 90 degrees loading, the highest values of sigma(max) were recorded for the lowest modulus posts, on the cervical region, with a direction that suggests debonding of the post. For the 0 degrees loading, the highest values of sigma(max) were recorded for higher modulus posts, on the apical region, and the circumferential direction suggests vertical root fracture. The hypothesis was accepted: the effect of the elastic modulus on the magnitude and direction of the sigma(max) generated on the root was dependent on the loading direction.

Introduction: This study evaluated the bond strength of translucent fiber posts to experimentally weakened radicular dentin restored with composite resin and polymerized with different light-exposure time., Methods: Roots of 60 maxillary incisors were used. Twenty-four hours after obturation, the filling materials of root canals were removed to a depth of 12 mm, and 4 groups were randomly formed. In 3 groups, root dentin was flared to produce a space between fiber post and canal walls. In the control group, the roots were not experimentally weakened. The flared roots were bulk restored with composite resin, which was light-activated through the translucent post for 40, 80, or 120 seconds. Posts were cemented, and after 24 hours, all roots were sectioned transversely in the coronal, middle, and apical regions, producing 1-mm-thick slices. Push-out test was performed, and failure modes were observed., Results: The quantitative analysis showed significant statistical difference only among groups (P < .001). Comparing the weakened/restored groups, composite light-exposure time did not influence the results. Overall, adhesive failures occurred more frequently than other types of failures. Cohesive failures occurred only in the weakened/restored roots., Conclusions: Intracanal root restoration with composite resin and translucent fiber posts provided similar or higher bond strength to dentin than the control group, regardless of the light-exposure time used for polymerization.

Erbium, chromium: yttrium, scandium, gallium, garnet (Er,Cr:YSGG) lasers are currently being investigated for disinfecting the root canal system. Prior to using laser therapy, it is important to understand the temperature distribution and to assess thermal damage to the surrounding tissue. In this study, a theoretical simulation using the Pennes bioheat equation is conducted to evaluate how heat spreads from the canal surface using an Er,Cr:YSGG laser. Results of the investigation show that some of the proposed treatment protocols for killing bacteria in the deep dentin are ineffective, even for long heating durations. Based on the simulation, an alternative treatment protocol is identified that has improved effectiveness and is less likely to introduce collateral damage to the surrounding tissue. The alternative protocol uses 350 mW laser power with repeating laser tip movement to achieve bacterial disinfection in the deep dentin (800 microm lateral from the canal surface), while avoiding thermal damage to the surrounding tissue (T<47 degrees C). The alternative treatment protocol has the potential to not only achieve bacterial disinfection of deep dentin but also shorten the treatment time, thereby minimizing potential patient discomfort during laser procedures.

Enamel, dentine and cementum are dental tissues with distinct functional properties associated with their unique hierarchical structures. Some potential ways to repair or regenerate lost tooth structures have been revealed in our studies focused on examining teeth obtained from mice with mutations at the mouse progressive ankylosis (ank) locus. Previous studies have shown that mice with such mutations have decreased levels of extracellular inorganic pyrophosphate (PP(i)) at local sites resulting in ectopic calcification in joint areas and in formation of a significantly thicker cementum layer when compared with age-matched wild-type (WT) tissue [Ho AM, Johnson MD, Kingsley DM. Role of the mouse ank gene in control of tissue calcification and arthritis. Science 2000;289:265-70; Nociti Jr FH, Berry JE, Foster BL, Gurley KA, Kingsley DM, Takata T, et al. Cementum: a phosphate-sensitive tissue. J Dent Res 2002;81:817-21]. As a next step, to determine the quality of the cementum tissue formed in mice with a mutation in the ank gene (ank/ank), we compared the microstructure and mechanical properties of cementum and other dental tissues in mature ank/ank vs. age-matched WT mice. Backscattered scanning electron microscopy (SEM) imaging and transmission electron microscopy (TEM) analyses on mineralized tissues revealed no decrease in the extent of mineralization between ank/ank cementum vs. WT controls. Atomic-force-microscopy-based nanoindentation performed on enamel, dentine or cementum of ank/ank vs. age-matched WT molars revealed no significant difference in any of the tested tissues in terms of hardness and elastic modulus. These results indicate that the tissue quality was not compromised in ank/ank mice despite faster rate of formation and more abundant cementum when compared with age-matched WT mice. In conclusion, these data suggest that this animal model can be utilized for studies focused on defining mechanisms to promote cementum formation without loss of mechanical integrity.

Background: Post design and material has very important effects on dentinal stress distribution since the post placement can create stresses that lead to root fracture., Materials and Methods: In this study we use finite element analysis (FEA) to evaluate stress distribution on endodontically treated maxillary central incisors that have been restored with different prefabricated posts. Six models were generated from the image of anatomical plate: Four metallic posts (ParaPost XH, ParaPost XT, ParaPost XP, and Flexi-Flange) and one fiberglass post (ParaPost Fiber Lux). The sixth model was a control-a sound maxillary central incisor. We used CAD software and exported the models to ANSYS 9.0. All the materials and structures were considered elastic, isotropic, homogeneous, and linear except the fiberglass post which was considered orthotropic. The values for the mechanical properties were obtained by a review of the literature and the model was meshed with 8-node tetrahedral elements. A load of 2N was applied to the lingual surface at an angle of 135 degrees., Results: The stress results were recorded by shear stress and von Mises criteria; it was observed that there was no difference for stress distribution among the titanium posts in the radicular portions and into posts. There was higher stress concentration on the coronary portion with the titanium posts than with the glass fiber post. It seems that the metallic posts' external configuration does not influence the stress distribution., Conclusion: Fiber posts show more homogeneous stress distribution than metallic posts. The post material seems to be more relevant for the stress distribution in endodontically treated teeth than the posts' external configuration.

Bioabsorbable bone plates can eliminate the necessity for a permanent implant when used to fixate fractures of the human mandible. They are currently not in widespread use because of the low strength of the materials and the requisite large volume of the resulting bone plate. The aim of the current study was to discover a minimally invasive bioabsorbable bone plate design that can provide the same mechanical stability as a standard titanium bone plate. A finite element model of a mandible with a fracture in the body region is subjected to bite loads that are common to patients postsurgery. The model is used first to determine benchmark stress and strain values for a titanium plate. These values are then set as the limits within which the bioabsorbable bone plate must comply. The model is then modified to consider a bone plate made of the polymer poly-L/DL-lactide 70/30. An optimization routine is run to determine the smallest volume of bioabsorbable bone plate that can perform and a titanium bone plate when fixating fractures of this considered type. Two design parameters are varied for the bone plate design during the optimization analysis. The analysis determined that a strut style poly-L-lactide-co-DL-lactide plate of 690 mm2 can provide as much mechanical stability as a similar titanium design structure of 172 mm2. The model has determined a bioabsorbable bone plate design that is as strong as a titanium plate when fixating fractures of the load-bearing mandible. This is an intriguing outcome, considering that the polymer material has only 6% of the stiffness of titanium.

The current study evaluated the influence of two endodontic post systems and the elastic modulus and film thickness of resin cement on stress distribution in a maxillary central incisor (MCI) restored with direct resin composite using finite element analysis (FEA). A three-dimensional model of an MCI with a coronary fracture and supporting structures was performed. A static chewing pressure of 2.16 N/mm2 was applied to two areas on the palatal surface of the composite restoration. Zirconia ceramic (ZC) and glass fiber (GF) posts were considered. The stress distribution was analyzed in the post, dentin and cement layer when ZC and GF posts were fixed to the root canals using resin cements of different elastic moduli (7.0 and 18.6 GPa) and different layer thicknesses (70 and 200 microm). The different post materials presented a significant influence on stress distribution with lesser stress concentration when using the GF post. The higher elastic modulus cement created higher stress levels within itself. The cement thicknesses did not present significant changes.

Aim: To determine whether resin-based sealer cements are able to strengthen root dentine, as measured by work of fracture (Wf), micro-punch shear strength (MPSS) and resistance to vertical root fracture (VRF)., Methodology: One hundred and twenty extracted premolar teeth were randomly assigned amongst four treatments before testing: intact, root canals prepared but unfilled, or root filled using epoxy- or urethane dimethacrylate (UDMA)-based sealer (plus core material). Samples were then prepared for measuring Wf, MPSS or VRF using standard test procedures. Data were analyzed using one-way anova with significance set at P < 0.05., Results: For all three tests, root canals filled using epoxy resin-based sealer were not statistically significantly different compared with UDMA resin (P = 1 for Wf, P = 0.7 for MPSS and P = 0.12 for VRF), or different from both sound and prepared dentine (P > 0.05). There was also no significant difference between sound dentine and prepared dentine for both Wf (P = 0.92) and resistance to VRF (P = 1)., Conclusions: Neither epoxy nor UDMA resins used as sealer cements enhanced fracture resistance of root dentine when placed within root canals of extracted teeth.

The aim of this general article is to present an overview of the current knowledge about composition and structural changes and also about specific biomechanical alterations related to vitality loss or endodontic therapy. For a long time, these issues have been controversially approached from a clinical standpoint and are therefore still confusing for many practitioners. Vitality loss or endodontic procedures seem to induce only negligible changes in hard dental tissue moisture. Physico-chemical properties of dentin can be modified by some of the endodontic chemical products used for chemo-mechanical debridement. On the other hand, tooth biomechanical behavior is affected, since tooth strength is reduced proportionally to coronal tissue loss, due to either pre-existent carious/non-carious lesions or cavity acces preparation, besides restorative procedures. The related literature shows the lack of accepted clinical standards and consensus regarding the optimal way of approaching the specific tooth biomechanics following endodontic therapy.

Objective: Previous in vitro studies have described the wear characteristics of specimens in which enamel has been opposed to enamel and dentine opposed to dentine. The aim of this study was to assess the characteristics of wear between specimens in which enamel was opposed to dentine at loads simulating attrition and at pH values simulating different erosive environments. It was hypothesized that enamel would wear more slowly than dentine under all conditions., Design: Opposing enamel and dentine specimens from 57 human third molar teeth were worn in electromechanical machines with various loads (32, 62 and 100 N) and lubricants (pH 1.2, 3.0 and 6.1). Tooth wear was quantified by measuring reduction in dentine volume over time using a 3D profilometer. Qualitative assessment was also carried out using scanning electron microscopy., Results: Dentine wear increased with increasing load, and dentine wear was faster at pH 1.2 than at pH 3.0 or 6.1 for all loads tested. Interestingly, enamel wore more rapidly than dentine at pH 1.2 under all loads. At pH values of 3.0 and 6.1, enamel wear rates were not measurably different from zero and they were less than wear rates for opposing dentine specimens at all loads. Micrographic assessment showed extensive surface destruction of dentine wear facets due to erosion at pH 1.2. Dentine wear facets were smoother at pH 3.0 that at pH 6.1., Conclusions: When enamel wears against dentine in an acidic environment enamel will wear more rapidly at very low pH, while under less acid conditions dentine will wear faster than enamel.

Aim: Aim of this work was to carry out a comparative evaluation of the structural behaviour of different root canal posts (cylindrical, conical and triple conical) fitted in a second lower bicuspid and subjected to compression and bending test., Materials and Methods: This study has been carried out by numerical method of structural analysis of finite elements (FEM, Finite Element Method). Different tridimensional models were obtained by CAT images of an extracted tooth, endodontically treated, filled with guttapercha and triple conical glass post. Images have been elaborated by a software for images (Mimics and Ansys) and CAD (Rhinoceros 3 D). In the models a II Class restoration has been virtually created. In the numerical simulation dental tissues (enamel, dentine and root cement), guttapercha, root canal cement, different posts, different techniques of cementation and crown restoration (composites and adhesive systems) have been considered., Results: Strain distributions in dental tissues, in root canal cement and in posts have been compared. The equivalent tensions and the single components (traction, compression and cut) have been analysed. In all examined posts, the most strained part is resulted the coronal one, even if the total tension, in the different tooth-post analyzed systems, resulted uniformly distributed. A similar behaviour was shown by the root canal cement., Conclusions: According to the analyzed conditions of bond and load, varying according to the geometry of the considered posts, our results confirm that there is no substantial difference of deformation in posts, root canal cement and treated tooth.

Objectives: To evaluate the longevity of sound (SD) and caries-affected dentin (CAD) bonds made with etch-and-rinse and self-etching adhesives after a 6-month water-storage period, using bond strength and morphological evaluations., Methods: Extracted human molars with coronal carious lesions were selected. Flat surfaces of CAD surrounded by SD were bonded with etch-and-rinse (Adper Scotchbond 1) or with self-etching (Clearfil Protect Bond and AdheSE) adhesives. Trimmed resin-dentin bonded interfaces (1mm2) were stored in distilled water for 24h or 6 months and subjected to microtensile bond strength (microTBS) evaluation. The quality of the dentin beneath fractured specimens was measured by Knoop microhardness (KHN). ANOVA and multiple comparisons tests were used (P<0.05). Fractographic analysis and interfacial nanoleakage evaluation were performed by scanning electron microscopy (SEM). Resin-dentin bonded sections (10microm thick) were stained with Masson's trichrome and examined using light microscopy. Collagen exposure and adhesive penetration were examined qualitatively., Results: microTBS to SD was significantly higher than that to CAD for all bonding agents. Bonds made with AdheSE were weaker than the other adhesives after 6-months storage regardless of the dentin substrate. CAD bonded specimens presented a significant muTBS decrease over time. Lower KHN was recorded in CAD compared to SD. An increase in the exposed collagen zone and a decrease in the quality of the adhesive infiltration were observed in CAD interfaces., Significance: CAD bonded interfaces are more prone to hydrolytic degradation than SD bonds. Additionally, as compared to SD, there were remarkable differences in depth of demineralization, adhesive infiltration and interfacial bond strength with CAD.

The purpose of this study was to compare the temperature rise under normal and caries-affected primary tooth dentin during photopolymerization of two adhesives and resin-containing restorative materials. Caries-affected and normal dentin disks were prepared from extracted primary molars with only mesial or distal approximal caries (4 mm in diameter, 1 mm in height). Temperature rise during photopolymerization of adhesive materials was measured with a J-type thermocouple wire that was connected to a data logger. Data were analyzed with two-way ANOVA and independent samples t-test. Temperature rise under caries-affected primary tooth dentin disks was higher than that of normal primary tooth dentin disks during polymerization of both adhesive systems and resin-containing dental materials (p < 0.05). It was found that adhesive systems induced a higher temperature rise during polymerization as compared to the resin-containing restorative materials (p < 0.05). In particular, temperature rise during polymerization of adhesive materials exceeded 5.5 degrees C under caries-affected primary tooth dentin.

Purpose: To compare the in vitro fracture resistance and the microtensile bond strength (muTBS) of premolar teeth restored with two light-cured resin composite inlay systems., Methods: 50 sound human maxillary premolars were divided randomly into five equal groups. Four groups received mesial-occlusal-distal (MOD) inlay preparations. Restorative treatments comprised: Group 1 (Renew direct resin composite), Group 2 (Renew direct resin composite inlay), Group 3 (Tescera indirect resin composite inlay), Group 4 (non-restored), Group 5 (intact). All teeth were loaded axially until fracture. The same resin-based materials as used in Groups 1-3 were bonded to the superficial coronal dentin of 15 teeth. Beams approximately 1.0 mm x 1.0 mm were prepared and tested in microtensile mode. Results were compared using one-way ANOVA and Tukey's multiple comparison tests., Results: Mean fracture strengths (KN): Group 1, 2.06 (0.76); Group 2, 2.30 (0.49); Group 3, 2.62 (0.68); Group 4, 1.24 (0.44); Group 5, 2.40 (0.71). Group 4 was significantly weaker that the other four groups, P < 0.01. Mean muTBSs (MPa): Group 1, 33.38 (6.24); Group 2, 20.38 (6.24); Group 3, 20.87 (4.62). Group 1 was significantly stronger than the other two groups, P < 0.01.

Reconstitution of carious dentin has been recognized as difficult, because it progresses by loss of collagen polymerization and by demineralization under acidic conditions. Recently, colloidal alkaline nano-calcium phosphate, prepared by electrical discharge in a buffered physiological saline solution, has been shown to be effective in the formulation of a bone-like biocomposite by simply being mixed with acidic collagen solution. It was hypothesized that colloidal calcium phosphate was suitable for the reconstitution of carious dentin. Natural caries lesions in dentin from permanent teeth were exposed to colloidal hydroxyapatite and beta-tricalcium phosphate for 10 days. The micromechanical properties of these tissues were evaluated by nano-indentation. The elastic modulus of human carious dentin improved after samples were immersed in colloidal beta-tricalcium phosphate. The mineral density of carious dentin exposed to beta-tricalcium phosphate increased more than that immersed in hydroxyapatite. However, since it was not directly proportional to micromechanical recovery, mineral density alone was not a sufficient indicator of mechanical behavior.

Objective: To determine the relationship between pain intensity and the rate of fluid flow through dentine in human subjects., Design: The experiments were carried out on 16 premolars in 13 human subjects (aged 15-25 years). Dentine was exposed at the tip of the buccal cusp, etched with acid and covered with saline. A series of 5 s hydrostatic pressure stimuli between 400 mmHg above and 400 mmHg below atmospheric were applied to the dentine, in steps of 50 mmHg. The subject indicated the intensity of any pain produced on a visual analogue scale (VAS). The fluid flow through dentine during application of the same stimuli was measured in vitro within 3 h after tooth extraction., Results: The median pain threshold with negative (subatmospheric) stimuli was -125 mmHg and, with positive pressure stimuli, 200 mmHg, which corresponded to dentinal fluid flow rates of 3.29 nL/(s mm(2)) exposed dentine and 5.75 nL/(s mm(2)), respectively. Both the median pressure and the mean rate of flow at threshold with negative pressures were significantly lower than with positive pressures. The curves relating VAS score to stimulus intensity were similar with both negative and positive pressures., Conclusion: The sensory transduction mechanism for pain in human teeth is more sensitive to outward than inward flow through dentinal tubules. The difference in sensitivity was however much less than that of the hydrodynamic receptors in the cat, which respond very much more strongly to negative than positive pressure stimuli.

The aim of this study was determine whether bonding of glass-ionomer cements to non-carious dentine differed from that to carious dentine. Five commercial cements were used, namely Fuji IX GP, Fuji IX capsulated, Fuji IX Fast capsulated (all GC, Japan), Ketac-Molar and Ketac-Molar Aplicap (both 3M-ESPE, Germany). Following conditioning of the substrate with 10% poly (acrylic acid) for 10 s, sets of 10 samples of the cements were bonded to prepared teeth that had been removed for orthodontic reasons. The teeth used had either sound dentine or sclerotic dentine. Shear bond strengths were determined following 24 h storage. For the auto-mixed cements, shear bond strength to sound dentine was found not to differ statistically from shear bond strength to sclerotic dentine whereas for hand-mixed cements, shear bond to sound dentine was found to be higher than to carious dentine (to at least p < 0.05). This shows that the chemical effects arising from interactions of glass-ionomer cements with the mineral phase of the tooth are the most important in developing strong bonds, at least in the shorter term.

This article presents an in vitro analysis of a specific occlusal loading test on endodontically treated teeth restored with 2 different composite post materials. Individual, customized posts (IFPs) were compared to standard fiberglass posts (SFPs). The selected IFPs (standard cylindric Targis/Vectris posts) were compared to SFPs (Conic 6% Post, Ghimas). The posts were first subjected to a 3-point bending test to compare their flexural elastic properties. They were then used to restore 22 endodontically treated artificial maxillary central incisors and subjected to a specific occlusal loading simulation test. The loading test showed that IFP restorations performed better than SFP restorations. A clinical evaluation of this laboratory observation is suggested.

Aim: To determine whether application of a periodontal dressing stopped pain arising from dentine hypersensitivity, objectively assessed with evaporative and thermal stimuli and recorded with Visual Analogue Scale scoring (VAS)., Materials and Methods: 22 subjects completed the single-centre, subject-blind, stratified, randomized, split-mouth study, with a minimum of two sensitive teeth, in at least two different quadrants, displaying a response of >or=30 mm with VAS to evaporative stimulus. One tooth in two different quadrants was identified and randomized to test or control groups. A dressing was applied to all the sensitive teeth in the test quadrant, and either side of the chosen sensitive tooth on the control side. The test teeth were then stimulated for hypersensitivity using evaporative stimuli and then using thermal stimuli., Results: Analysis showed that dressing application produced significantly greater reduction in pain (P<0.0001) compared with no periodontal dressing. Single application of a dressing to sensitive dentine provided 95% pain relief associated with thermal stimulus and 85% pain relief associated with evaporative stimulus., Conclusions: Application of the dressing to sensitive teeth, dramatically reduced the pain of dentine hypersensitivity following tooth stimulation. When assessing subjects' response to pain-evoking stimuli, perception of pain appears to be altered by sensory factors, prompting a heightened pain response.

Aim: To investigate the fracture resistance and fracture patterns of teeth restored with composite cores supported by different pre-fabricated post systems and different heights of remaining coronal dentine., Methodology: Four groups of 30 single rooted teeth were used. Each group was divided into three subgroups of 10 teeth each and restored with carbon fibre, glass fibre, or Radix titanium posts luted with dual cure resin cement. The control group A had no retained coronal dentine. Groups B, C and D had 2, 3 and 4 mm of retained buccal and lingual coronal dentine, respectively. Teeth were tested to failure using an Instron Universal Testing Machine. Subsequently, the fracture mode of specimens was recorded., Results: Teeth with retained dentine were more resistant to fracture (P = 0.001). Tooth fracture resistance was not significantly different between groups B, C and D. Within group A, titanium posts were associated with higher fracture resistance than fibre posts. Within the other groups, tooth fracture resistance was not related to post material. Within groups C and D, fracture resistance of teeth restored with carbon fibre posts was significantly higher than those restored with glass fibre posts. The dominant fracture mode in group A was core and vertical oblique root fracture whilst a combination of core, coronal dentine and root fracture occurred in the other groups., Conclusions: Fracture resistance of teeth increased with the presence of retained coronal dentine. The use of glass and carbon fibre posts did not improve the fracture resistance or the fracture pattern of teeth when compared with metal titanium posts regardless of the presence of retained coronal dentine. The dominant fracture pattern of teeth was not related to the amount of retained dentine if it was >2 mm high.

Mice harboring the Col1a2(oim) mutation (oim) express dentinogenesis imperfecta. To determine the effect of Col1a2 genotype on tissue mechanical properties, we compared Young's modulus and hardness of dentin in the 3 Col1a2 genotypes. Upper incisors were tested by nanoindentation. Genotype had a significant effect on Young's modulus, but there was not a simple mutant allele dosage relationship. The effect of genotype on hardness did not reach significance. Hardness and Young's modulus were greater near the dento-enamel junction than near the pulp chamber. Greater hardness and Young's modulus values near the dento-enamel junction reflected continued mineralization of the dentin following its initial synthesis. Analysis showed the mechanical data to be consistent with Fourier transform infrared and backscattered electron microscopy studies that revealed increased mineralization in oim bone. Analysis of the data suggests that clinical fragility of teeth in oim mice is not due to deficiencies of hardness or Young's modulus, but may be due to defects in post-yield behavior or resistance to fatigue damage.

Objectives: To date, there has been no attempt to assess the mechanical properties of the entirety of a smooth-surface carious lesion in primary teeth, despite the fact that these lesions are not only common, but clinically challenging. Therefore, the aim of this study was to describe the hardness and modulus of elasticity across smooth surface lesions of primary incisors., Study Design: An in vitro study of the micromechanical properties of primary incisors., Materials and Methods: Carious primary incisor teeth were set in resin, sectioned and polished. A series of indentations using the ultra-micro-indentation system were conducted in fully hydrated carious and sound dentine from the minimally affected pulpal region towards the tooth surface. A single set of indentations were duplicated for sound dentine., Results: Although the mechanical properties of the carious dentine varied between the test teeth, the median hardness of the surface, middle and inner (pulpal) region of the carious dentine was 0.01, 0.10 and 0.28 GPa, respectively. The modulus of elasticity of the surface, middle and inner (pulpal) carious dentine was 0.12, 2.16 and 5.98 GPa, respectively. The mechanical properties of the sound dentine varied less, and were consistent between the pulpal and surface regions. Examination of the individual series of indentations indicated that, although the majority of the test teeth showed a decrease in the mechanical properties from the 'unaffected dentine' to the surface of the lesion, in the last 300-500 microm, both the hardness and modulus of elasticity showed a dramatic increase., Conclusions: This study has confirmed that the carious process has a deleterious effect on the mechanical properties of dentine in primary incisors. This, in turn, increases the likelihood of restorative failure. However, the slight increase in mechanical properties seen at the surface of the carious lesion suggests an increase in mineral content.

Aim: To analyse the effect of ferrule height upon the mechanical resistance and stress distribution within a root to explain variations in the pattern of root fracture., Methodology: An extracted, intact, caries free, maxillary right central incisor was scanned by laser and then reconstructed on a computer to produce a model of the tooth and associated periodontal ligament. A simulated post/core/crown restoration was constructed on conventional tooth preparations with various ferrules. The crown was loaded with a simulated 500 N force and the simulated displacement of components and the tensile and compressive stress within the tooth structure were recorded., Results: Without a ferrule preparation, the simulated crown tilted to the labial and rotated distally. With increasing ferrule height the displacement and rotation of the crown reduced in conventional and crown-lengthening models with maximum reduction occurring when the ferrule height reached 1.5 mm. In ferrule models, higher levels of tensile stress developed in internal (by a factor of 8) and mid-root palatal (by a factor of 90) dentine at the cervical margin of the preparation. With an increase in ferrule height, the area of tensile stress within the palatal mid-dentine expanded towards the cervical margin. Similar patterns and stress values were recorded for the crown-lengthening models., Conclusion: The study confirms that a ferrule increases the mechanical resistance of a post/core/crown restoration. However a ferrule creates a larger area of palatal dentine under tensile stress that may be a favourable condition for a crack to develop. Crown-lengthening did not alter the levels or pattern of stress within compared with conventional ferrule preparations.

A preliminary study of the effects from age and dehydration on fatigue crack growth in human dentin was conducted. Compact tension (CT) fatigue specimens of coronal dentin were prepared from extracted molars and subjected to high cycle fatigue (10(5)

Dentinogenesis imperfecta (DGI) and dentin dysplasia (DD) are allelic disorders that primarily affect the formation of tooth dentin. Both conditions are autosomal-dominant and can be caused by mutations in the dentin sialophosphoprotein gene (DSPP, 4q21.3). We recruited 23 members of a four-generation kindred, including ten persons with dentin defects, and tested the hypothesis that these defects are linked to DSPP. The primary dentition showed amber discoloration, pulp obliteration, and severe attrition. The secondary dentition showed either pulp obliteration with bulbous crowns and gray discoloration or thistle-tube pulp configurations, normal crowns, and mild gray discoloration. Haplotype analyses showed no recombination between three 4q21-q24 markers and the disease locus. Mutational analyses identified no coding or intron junction sequence variations associated with affection status in DMP1, MEPE, or the DSP portion of DSPP. The defects in the permanent dentition were typically mild and consistent with a diagnosis of DD-II, but some dental features associated with DGI-II were also present. We conclude that DD-II and DGI-II are milder and more severe forms, respectively, of the same disease.

This study evaluated the stress distribution on an endodontically treated maxillary central incisor restored with different post-and-core systems by using a three-dimensional finite element analysis model. Seven three-dimensional finite element models were created. Each model contained cortical bone, cancelous bone, periodontal ligament, 3 mm apical root canal filling, post-and-core and all-ceramic crowns. Two different pre-fabricated zirconia ceramic post systems, a glass fiber-reinforced post system and a titanium post system were modeled. As a control, an all-ceramic crown on an endodontically treated maxillary central incisor without a post-and-core was modeled. Each model received a 45 degrees oblique occlusal load at a constant intensity of 100 N. In each model, the ratio of Von Mises stress distribution was compared. The greatest stresses were observed in the coronal third of the roots on facial surfaces. The ratio of Von Mises stress distribution in dentin for the zirconia ceramic post (CosmoPost) and ceramic core (Cosmo Ingot), zirconia ceramic post (CosmoPost) and composite core (Tetric Ceram), glass fiber-reinforced post (FRC Postec) and composite core (Tetric Ceram), titanium post (Er post) and composite core (Tetric Ceram), zirconia ceramic post (Cerapost) and ceramic core (Cosmo Ingot), zirconia ceramic post (Cerapost) and composite core (Tetric Ceram) and the control group were 0.886, 0.889, 0.988, 0.924, 0.889, 0.893 and 1, respectively. The stress concentrations in dentin created by two different zirconia ceramic post systems were nearly the same. The zirconia ceramic post systems created slightly less stress concentration in dentin than the glass fiber-reinforced and titanium posts.

Many clinical reports suggest that deciduous teeth exhibit a greater susceptibility to resorption than permanent ones. To examine the difference between deciduous and permanent dentine in their susceptibility to osteoclastic resorption, osteoclast-like cells (OCLs) were cultured on deciduous and permanent dentine slices. The number, area, depth, and volume of resorption pits were then measured, using image-analyzing systems. We measured the level of degraded collagen (cross-linked N-telopeptide of type I collagen; NTx) in culture medium using an enzyme-linked immunosorbent assay (ELISA). The levels of cathepsin K, matrix metallo proteinase (MMP)-9, and MMP-13 mRNAs in the cells attached to dentine were also analyzed by real-time reverse transcription polymerase chain reaction (RT-PCR). Deciduous dentine slices exhibited a significant (twofold) increase in resorbed area compared with the permanent slices. Three-dimensional analysis revealed that the volume of pits in deciduous dentine differed significantly (fourfold) compared to that in the permanent dentine. The depth of pits also followed the same trend. However, there was no significant difference in the number of pits or osteoclasts on the dentine slices. The NTx level in deciduous media was significantly more than that in permanent media. The mRNA levels also followed the same trend. These results suggest that deciduous dentine is more susceptible to resorption than permanent dentine and signals from the substrate play an important role in physiological resorption.

Background: This study aimed to evaluate microhardness and chemical analysis of carious and caries-affected dentine. The hypothesis tested was that calcium:phosphorous (Ca:P) ratios correlate with microhardness values., Methods: Four carious human third molars were sectioned through the caries lesion in the mesiodistal longitudinal plane. One half of each lesion underwent carious dentine removal using Carisolv gel. The cut surfaces were polished, microhardness tested using an Ultra-Micro-Indentation System (UMIS) and elemental analysis performed using energy dispersive analysis of x-rays (EDAX)., Results: The microhardness of carious dentine decreased gradually towards the cavity floor, but that for caries-affected dentine showed more variation with depth, having a mean hardness of (0.63 +/- 0.18) GPa. Ca:P ratios of carious dentine varied among the four specimens. The mean Ca:P ratio of caries-affected dentine was 1:2.03 +/- 0.08. The hypothesis was accepted for active lesions., Conclusions: The use of Carisolv to excavate carious tissue can be as effective as rotary instrumentation.

The bond strengths of resins to caries-affected dentin are low. This could be due to weakened organic matrix. The purpose of this work was to determine if the ultimate tensile strength (UTS) of excavated carious dentin is weaker than that of normal dentin. Soft caries was excavated from extracted human molars, and the tooth was vertically sectioned into slabs. Each slab was trimmed to an hourglass shape, parallel or perpendicular to the tubule direction. Half of the specimens were mineralized, while the other half were completely demineralized in EDTA. ANOVA on ranks showed that the three-factor interactions (mineralization, caries, tubule direction) were all significant (p < 0.0001), indicating that mineralization and tubule direction gave different UTS results in normal and caries-affected dentin. No significant differences were seen between the UTS of normal and and that of caries-affected demineralized dentin in the parallel or perpendicular group. The matrix of demineralized caries-affected dentin was as strong as that of normal demineralized dentin when tested in the same direction.

Statement of Problem: Endodontically-treated, dowel-restored teeth may experience fracture, but investigations of variables related to fracture are often inconclusive and occasionally contradictory., Purpose: The finite element method was used to analyze the stresses in dowel-restored teeth. The variables studied were material, shape, bonding, modulus of elasticity, diameter, and length of the dowel., Material and Methods: The model of the dowel-restored tooth involved dentin, ligament, cortical and trabecular bone, gingiva, and gutta-percha. The dowels were made of glass fiber, titanium, or zirconia and modeled as an approximation of the brands ParaPost Fiber White, ParaPost XH, and Cerapost, respectively. The dowel was cemented with zinc-phosphate cement or with bonded or nonbonded resin luting agents, and an approximation of the material properties of these 2 materials were used in the modeling. The restoration included a composite resin core and a gold crown. Other variables included taper versus parallel-sided posts, modulus of elasticity, diameter, and length of post. The model was axisymmetrical in 3 dimensions. A load of 100 N was applied to the crown at an angle of 45 degrees, and tensile, shear, and von Mises stresses were calculated., Results: The generated stresses decreased with respect to the dowel material in the following order: glass fiber, titanium, and zirconia. Stresses were in general higher with tapered than with parallel-sided dowels. Stresses were reduced by bonding and with an increasing modulus of elasticity, increasing diameter, and increasing length of the dowel., Conclusions: Within the limitations of this study, it was found that all investigated dowel-related factors influenced the stress field generated in dowel-restored teeth.

The aim of this study was to explore and compare the results of occlusal load application to cusp-replacing composite restorations, studied by means of finite element (FE) analysis and in vitro load tests. A three-dimensional (3D) FE model was created with a set up similar to an in vitro load test that assessed the fatigue resistance of upper premolars with buccal cusp-replacing resin composite restorations. Occlusal load was applied to two geometries (with and without palatal cuspal coverage), and the tooth-restoration interface and composite material stresses were calculated. Subsequently, safety factors were calculated by dividing the material strength values by the obtained stresses. The highest safety factors were observed for the restorations with cuspal coverage. This was consistent with the load test, in which cuspal coverage led to higher fracture resistance. Furthermore, the FE analysis predicted that failure of the tooth-restoration interface is more likely than failure of the composite material. Correspondingly, the load test showed predominantly adhesive failures of the restorations. Although the described test methods did not lead to a complete understanding of the failure mechanism, it can be concluded that the FE analysis provides additional information with regard to the differences in fracture behaviour of these types of restorations.

Statement of Problem: The dentino-enamel junction (DEJ) durably unites dissimilar hard brittle enamel and tough flexible dentin. In contrast to artificial bonds between restorations and dentin, the DEJ rarely fails except when it is affected by inherited disorders. Knowledge of DEJ toughening mechanisms is important in understanding inherited disorders, in biomimetic engineering of junctions between artificial restorations and teeth, and in tissue-engineering a DEJ., Purpose: The purpose of this study was to identify specific DEJ-zone failure mechanisms and to survey the fracture toughness of the human DEJ zone., Material and Methods: Fracture toughness indentations were made at 3 sites across the DEJ zone of 10 human incisor teeth. Failure modes identified using optical microscopy and fracture toughness (MPa.m(1/2)) were calculated following Vickers microindentation. Site mean values were then calculated and compared using 1-way analysis of variance (alpha=.05)., Results: The DEJ did not undergo catastrophic interfacial delamination; instead, damage was distributed over a broad zone. The primary damage mode involved cracking and damage dispersion in the specialized first-formed enamel close to the DEJ. Multiple, somewhat convoluted and sometimes branching, cracks spread and diffused damage over a wide area of adjacent enamel rather than producing catastrophic interfacial failure. Other secondary mechanisms included short microcracks in the DEJ adjacent dentin with possible cracked bridging, as well as plastic deformation of the DEJ without delamination. A DEJ-zone fracture toughness of approximately 0.8 to 0.9 MPa.m(1/2) was calculated., Conclusion: DEJ-zone damage occurred primarily within the adjacent layer of specialized first-formed enamel, and the optical DEJ interface resisted delamination.

The enamel is the toughest human tissue. The major component of the inorganic part is hydroxyl apatite (90-92%). The organic part of enamel is formed by proteins, proteoglycans and lipoids, and represents only 1-2% of the entire weight. The organic components are organized, forming histological structures like enamel lamellae, enamel rods sheaths, enamel spindles and tufts. The authors, with the aid of the scanning electron microscope and histochemical staining, have demonstrated that enamel lamellae presented a true histological structure, contrary to some opinions that consider this entities developmental failures or simple cracks. In the opinion of the authors, these lamellae confer elasticity to the enamel when exposed to lateral or tangential forces, or even torque. The lamellae are also considered pathways for the progression of dental caries. The dentine-enamel junction is another non-mineralized tooth-structure which functions like an elastic support for the tough enamel, opposing unfortunately a very low resistance in the face of dental caries progression. In such cases we talk about secondary enamel caries. The dentinal tubules with the organic structures inside are essential in maintaining the vitality of the dentine and enamel; but in pathological circumstances they represent pathways for pathological stimuli heading toward the pulp, and they are the weakest points in front of caries progression.

The damaging effect of temperature increase on the pulp tissue during restorative treatment has been a matter of concern in dentistry for many years. Aesthetic restorative dentistry relies on polymerization of light-activated resin composites which can cause damaging effects to the dental pulp as a result of temperature rise caused by both the exothermic reaction process and the energy absorbed during irradiation. This in vitro study was carried out to measure the increase in pulp chamber temperature induced during composite resin-polymerization with various light curing units in three different and common clinical situations (Veneer, Class II, Class III) and the clinical implications of the results. Measurement of pulp temperature changes during polymerization was performed with a Al-Cr Thermocouple positioned at the pulp-dentin junction. Mean values were calculated from six measurements with each light curing unit.

A better appreciation of the properties of carious dentine would be of clinical advantage in carious assessment and management. The aim of this study is to understand the deterioration of the mechanical properties of carious dentine as a result of bacterial demineralising process as well as change in dentine structures observed under scanning electronic microscope. Eight primary molar teeth with untreated carious dentine were axially sectioned and fine polished for nano-indentation. On each specimen, six lines of indentation, evenly distributed through the lesion, were made from the pulp to lesion cavity floor parallel to tubule direction using nano-indentation (Ultra Micro Indentation System, UMIS-2000), while another two indentation lines were made on an adjacent region of sound dentine in the same manner. All tests were conducted on hydrated specimens. Hardness and elastic modulus decreased significantly and progressively toward the cavity floor varying from 0.56 to 0.001 GPa and 14.55 to 0.015 GPa, respectively. The change in mechanical properties was in a specific pattern as a function of lesion depth, in which the hardness could be fitted to an exponential function, while the variation of the elastic modulus across the entire lesion was fitted to a power law relationship. More critical evaluation of the elastic modulus data indicated that two distinct exponential functions provided an excellent fit to the results. These changes in elastic modulus also matched the structural changes seen across a lesion, which were associated with a change from primarily peritubular to intertubular dissolution.

The effects of design parameters on crack growth along the adhesive layer in a resin-bonded first incisor/canine bridge are analysed using a finite element (FE) model in which allowance is made for tooth mobility by including elastic supports for the abutment teeth. The energy release rate, G, for incipient cracks in the adhesive layer are calculated for various crack lengths, metal frame configurations, frame thicknesses and tooth mobilities. Energy release rates for bridge frame designs with and without wrap round, denoted by G(w), and G(o), respectively, decrease as the metal frame thickness increases. The difference deltaG = G(o) - G(w), reaches a maximum with respect to the crack length, a, in the range 0.3 < a < 0.6mm, depending on the frame thickness. The effect of tooth mobility becomes increasingly important in the FE model as the overall stiffness of the bridge increases. Critical lengths for incipient cracks in the adhesive layer are estimated for a range of factors of safety against the onset of unstable crack propagation.

To date, much of our understanding of dentin bonding has been based on investigations performed on sound, healthy dentin. This is not the substrate generally encountered in clinical practice, rather dentists must frequently bond to caries-affected dentin. Because of the extreme complexity and variability of the caries-affected dentin substrate, conventional characterization techniques do not provide adequate information for defining those factors that impact bond formation. Using Fourier-transform infrared imaging, we characterized the inhomogeneities and compositional differences across the length and breadth of the caries-affected dentin/adhesive interface. Differences in mineral/matrix ratio, crystallinity, and collagen organization were noted in the comparison of caries-affected and healthy dentin. As compared to healthy dentin, there were striking differences in depth of demineralization, adhesive infiltration, and degree of conversion at the interface with caries-affected dentin., (2005 Society of Photo-Optical Instrumentation Engineers.)

Although the propagation of fatigue cracks has been recognized as a problem of clinical significance in dentin, there have been few fracture mechanics-based studies that have investigated this issue. In the present study, in vitro cyclic fatigue experiments were conducted over a range of cyclic frequencies (1-50 Hz) on elephant dentin in order to quantify fatigue-crack growth behavior from the perspective of understanding the mechanism of fatigue in dentin. Specifically, results obtained for crack extension rates along a direction parallel to the dentinal tubules were found to be well described by the stress-intensity range, DeltaK, using a simple Paris power-law approach with exponents ranging from 12 to 32. Furthermore, a frequency dependence was observed for the crack-growth rates, with higher growth rates associated with lower frequencies. By using crack-growth experiments involving alternate cyclic and static loading, such fatigue-crack propagation was mechanistically determined to be the result of a "true" cyclic fatigue mechanism, and not simply a succession of static fracture events. Furthermore, based on the observed frequency dependence of fatigue-crack growth in dentin and observations of time-dependent crack blunting, a cyclic fatigue mechanism involving crack-tip blunting and re-sharpening is proposed. These results are deemed to be of importance for an improved understanding of fatigue-related failures in teeth.

The aim of this study was to compare the resistance of endodontically treated teeth with intraradicular retainer different amounts of remaining coronal structure. Fifty freshly extracted maxillary canines were endodontically treated and randomly assigned to five groups (n=10), as follows: group 1 (control) = teeth with custom cast post and core; group 2 = teeth without remaining coronal structure; group 3, 4 and 5 = teeth with 1 mm, 2 mm and 3 mm of remaining coronal structure, respectively. All specimens in groups 2 to 5 were restored with prefabricated post and resin core. The teeth were embedded in acrylic resin and the fracture strength was measured on a universal testing machine at 45 degrees to the long axis of the tooth until failure. Data were analyzed statistically by one-way analysis of variance and Tukey's test. There was no significant differences (p>0.05) between the control group and group 2, and between groups 3, 4 and 5 (p>0.05). Control group and group 2 had significantly higher resistance strength than groups 3, 4 and 5 (p<0.00001). The findings of this study showed that teeth without remaining coronal structure had significantly higher fracture strength than those with remaining coronal structure (1 mm, 2 mm and 3 mm). When the dental crown was not completely removed, the amount of remaining coronal dentin did not significantly affect the fracture strength of endodontically treated teeth with intraradicular retainer.

In this study, the light-emission properties of carious and sound root surfaces were investigated under a wide range of excitation wavelengths. Human molar teeth with exposed root surfaces containing light- and dark-discolored root caries (n = 3 of each) were selected. Emission spectra were recorded from carious and corresponding sound root surface areas from each tooth by using a fluorescence spectrophotometer at excitation wavelengths from 360 nm up to 580 nm, in steps of 20 nm. The spectra were corrected for fluctuations in detector sensitivity and excitation light intensity, and normalized to peak intensity. Excitation spectra were recorded for selected emission wavelengths that showed maximum intensity. Light- and dark-discolored root surface caries showed distinct fluorescence emission bands between 600 and 700 nm that were not present in sound root surface areas. These bands were strongest for excitation wavelengths between 390 and 420 nm. The excitation spectra of root caries revealed maximum excitation at around 405 nm, which is equivalent to the Soret band of porphyrin compounds. The emission spectra of both types of root caries lesions were shifted towards longer wavelengths (red shift at half maximum) when compared to the spectra of corresponding sound root surfaces. The red shift for dark-discolored root caries was higher than for light-discolored lesions at all excitation wavelengths., (Copyright Eur J Oral Sci, 2004.)

The aims of the present study were to investigate the mechanical properties of first permanent molars affected with enamel hypomineralization or hypoplasia, and to describe the appearance of these lesions under scanning electron microscopy. Eight first permanent molar test teeth and two unaffected premolars (controls) were enclosed in resin, then sectioned axially and polished. The hardness and modulus of elasticity was determined from a single array of indentations made parallel to the amelo-dentinal junction using an Ultra-Micro-Indentation system. The teeth were then examined using the scanning electron microscope. The mechanical properties of the test teeth in the unaffected cervical region (hardness and modulus range, 2.03-4.99 GPa and 50.39-96.87 GPa, respectively) were similar to those of the control enamel (hardness and modulus range, 2.71-4.15 GPa and 62.06-95.77 GPa, respectively). Between the unaffected cervical enamel and the hypomineralized region there was a transitional area of 500-600 microm where the mechanical properties in the experimental teeth decreased linearly. The mechanical properties of the hypomineralized region of each experimental tooth were significantly lower than those of the control or cervical regions (hardness and modulus range, 0.07-1.74 GPa and 3.26-40.96 GPa, respectively). The scanning electron microscopy views revealed disorganized enamel with poorly demarcated prism boundaries in the affected regions. In conclusion, the hardness and modulus of elasticity of hypomineralized enamel in first permanent molars is significantly less than in unaffected areas of the same tooth. The reason for this is unclear but may be related to the lack of organization of the enamel crystals., (Copyright Eur J Oral Sci, 2004.)

This study was undertaken to examine the effects of the antiepileptics phenytoin and zonisamide on changes in the mineral density of the incisor and bone mineral density (BMD) of the mandibular head, and on the rate of dentin formation using histomorphometric measurements. After repeated administration of phenytoin or zonisamide to male growing rats, the mineral density of the lower incisors and mandibular head were determined by analyzing microradiographs and dentin formation rates were determined by histomorphometric measurements. Results showed a significant decrease in the mean values of BMD of the mandibular head and lower incisors in groups treated with phenytoin or zonisamide compared with the vehicle-treated group (p < 0.05). The percent rates of decrease in mineral density of the incisors for phenytoin and zonisamide were 6.8% and 4.0%, respectively. Phenytoin and zonisamide significantly reduced the dentin formation rate for the mesial and distal areas compared with the vehicle-treated group. Thus, epileptic children who are treated over a long period with antiepileptics, especially at primary school age, should ensure good oral hygiene so as not to suffer bone loss, edentulism or gingival overgrowth., (2004 Prous Science.)